Analysis of different methods in the treatment of incarcerated calculi in upper segment ureter complicated with ureteral tortuosity

Abstract

Objective To compare the efficacy and safety of flexible ureteroscopic lithotripsy （FUL）, percutaneous nephrolithotomy （PCNL） and retroperitoneal laparoscopic ureterolithotomy （RLU） in the treatment of the upper ureteral incarcerated calculi complicated with ureteral tortuosity. Methods Clinical data of 85 patients with the upper ureteral incarcerated calculi complicated with ureteral tortuosity were analyzed retrospectively. According to the stone treatment regimens, all patients were divided into the FUL group （n = 35）, PCNL group （n = 32） and RLU group （n = 18）. The operation time, intraoperative bleeding, stone clearance rate, length of postoperative hospital stay, postoperative visual analogue scale（VAS） score and incidence of postoperative complications were statistically compared among three groups. Results There was no statistical difference in the stone clearance rate and incidence of postoperative complications among three groups （all P > 0.05）. There were statistical differences in the operation time, hemoglobin decline, postoperative VAS score and length of postoperative hospital stay among three groups （all P < 0.05）. In the PCNL group, the largest amount of intraoperative bleeding and the most obvious postoperative pain were found. The operation time was the longest in the RLU group. In the FUL group, the shortest length of postoperative hospital stay was recorded （all P < 0.05 between any two groups）. Conclusions FUL, PCNL and RLU are safe and effective therapeutic options for patients with the upper ureteral incarcerated calculi complicated with ureteral tortuosity. Surgeons can choose appropriate surgical methods according to clinical experience.

Keywords

• |upper ureteral incarcerated calculus|ureteral tortuosity|flexible ureteroscopic lithotripsy|percutaneous nephrolithotomy|retroperitoneal laparoscopic ureterolithotomy|efficacy